NOCHS offers assistance to eligible individuals under its Financial Assistance Policy. To qualify for financial assistance, an individual must meet all of the following requirements.
• Be insured;
• Meet one of the following criteria:
o Reside within the cities of Grand Haven or Ferrysburg, the Townships of Grand Haven, Robinson or Crockery, or Spring Lake;
o Regularly seek medical care in the above locations; or
o Regularly receive medical care from a physician who regularly practices at NOCHS;
• Submit a complete Financial Assistance Application, including required supporting documents;
• Have limited liquid assets; and
• Have limited income, based on a comparison to Federal Poverty Guidelines.
An individual will not be eligible for finance assistance if their liquid assets exceed $35,000. An individual qualifies for a 100% discount if their income is less than 150% of FPG. An individual qualifies for a 75% discount if their income is between 150% and 200% of FPG. An individual qualifies for a 68% discount if their income is between 200% and 250% of FPG. A patient who is identified as deceased will qualify for a 100% financial assistance discount.
An individual who qualifies for financial assistance will not be required to pay more for emergency medical conditions and other medically necessary care than the amount generally billed to individuals who have insurance covering such care (the “AGB limit”).
Completed financial assistance applications and other documents should be submitted to LeAnn LaFrance/Ronald Sneed. Acceptable methods of submission are:
• Mail – “Attention: Financial Counselor”, 1309 Sheldon Road, Grand Haven MI 49417
• In-Person delivery - Financial Counselor, 1309 Sheldon Road, Grand Haven MI 49417
• Email – “Attention: Financial Counselor”, email@example.com or firstname.lastname@example.org
• Fax - “Attention: Financial Counselor”, 616.847-5573
Free copies of the Financial Assistance Policy and the Financial Assistance Application are available in printable PDFs below. Copies can be requested in-person in the hospital’s emergency room and in all admissions areas, by phone at 616-844-1590 or 1-866-814-5419 or by mail. At the individual’s request, the documents will be provided without charge in printed form, by mail, by fax or by email.
An individual who has questions about financial assistance or would like help with the application process can contact Financial Counselor office, LeAnn LeFrance or Ronald Sneed at NOCHS by calling 616-847-5272 or 616-844-4614 or by visiting 1309 Sheldon Road in Grand Haven.
Financial Assistance Policy (PDF)
Financial Assistance Application (PDF)